Medical device solutions for treating dental disease and methods for the treatment of dental disease

ABSTRACT

A medical device or solution for treating dental discomfort by at least partially occluding dental tubules is disclosed. The medical device or solution contains a polysaccharide or other biocompatible polymer with an antimicrobial metal, antimicrobial metal compound, or antimicrobial metal ion bound to a biopolymer. The medical device or solution further comprises at least one soluble antimicrobial. The soluble antimicrobial may be a water soluble metal iodide, water soluble metal fluoride, or a water soluble metal chloride encompassed with the nanogel. The medical device may be a solution of a chitosan with a nanoparticle of silver fluoride on the chitosan and at least one of a sodium fluoride or silver fluoride. The solution may be water based solution. Methods of applying the medical device or solution are also disclosed.

FIELD OF THE INVENTION

The invention relates generally to medical device and method for thetreatment of dental disease and dentinal tubules.

BACKGROUND

Currently there are a number of solutions for treating dental diseaseand caries. Some of these solutions attempt to remove the bacteriaphysically and insert a filling material such as a resin composite intothe weakened tooth structure, but these solutions fail to meet the needsof the industry because they are painful, expensive, and are treating abiochemical disease with mechanical methods.

Other solutions attempt to use fluoride supplements to converthydroxyapatite to fluorapatite, but these solutions are similarly unableto meet the needs of the industry because they aren't sufficientlybactericidal and don't have a prolonged effect. Still other solutionsseek to use silver diamine fluoride, but these solutions also fail tomeet industry needs because it requires a great deal of silver ions,stains the teeth and mucosa black, has an offensive taste, and has a pHwell above neutral causing a burning sensation in the patient's mouth.

SUMMARY OF THE INVENTION

It is desirable to have a medical device or solution that cansufficiently kill and inhibit the bacterial growth which may causedental disease, and which can be safely applied. Furthermore, it wouldalso be desirable to have a device that is easily applied. Stillfurther, it would be desirable to have a device that occludes dentinaltubules to reduce sensitivity. Still further, it would be desirable tohave a medical device or solution that remineralizes enamel and dentinof the tooth to prevent further decay. The disclosed medical device andsolutions and associated method advantageously fill these needs andaddresses the aforementioned deficiencies by providing a solution tokill and inhibit bacterial growth while simultaneously sealing andrepairing the tooth.

The invention is directed to a medical device or solution for occludinga dentinal tubule. Teeth are not a solid piece of body tissue. Rather,teeth are comprised of layers of tissues that each serve uniquefunctions. One of these layers, dentin, lies right under an enamelsurface covering of the tooth. Tubules are present in normal teeth thatpass through the dentin to help a person feel sensation in their teeth.While they are a part of normal tooth function, issues can arise.

Dentinal tubules are microscopic channels that radiate from theunderside of the enamel surface to the inside pulp of the tooth. Dentinis the major structural component and middle layer of the tooth,supporting the brittle enamel on the exterior surface. Dentin is lessmineralized than the enamel and forms the bulk of the tooth.

These small, hollow canals, tubules, in the dentin can convey sensationsfrom the outside of the tooth to the inside. This sensitivity can beuncomfortable for patients if the enamel surface is worn down orotherwise thinned exposing the dentin to more stimuli. The tubules maytransmit hot and cold sensation and sticky and acidic stimuli throughthe tooth. This stimulates the nerves and cells inside the tooth,causing discomfort.

These exposed or overstimulated dentinal tubules may be occluded toreduce the discomfort in a patient. Embodiments of the medical device orsolution may be applied to the tooth to occlude the dentinal tubule. Inone embodiment, the medical device or solution may comprise a nanogel orother polymer to carry an antimicrobial into the dentinal tubule to killmicrobes and at least partially seal the dentinal tubule to easediscomfort.

In another embodiment, the medical device or solution may comprise apolysaccharide or other biocompatible polymer; an antimicrobial metal,antimicrobial metal compound, or antimicrobial metal ion bound to thepolysaccharide or other biocompatible polymer. The medical device mayfurther comprise at least one of a water soluble metal iodide, watersoluble metal fluoride, and water soluble metal chloride encompassedwithin the nanogel or polymer.

The polysaccharide may include, but is not limited to, chitosan,dextran, or other low molecular weight polysaccharide. Thepolysaccharide may be a copolymer comprising a polysaccharide. In oneembodiment, the chitosan, dextran, nanogel, or other biocompatiblepolymer may have a molecular weight in the range of 50,000 to 200,000Da. The polysaccharide, chitosan, dextran or other biocompatible polymermay be modified to change its properties, if desired. In someembodiments, the biocompatible polymers may be functionalized orotherwise reacted to change the water solubility of the biocompatiblepolymer. For example, such biocompatible polymers may be deacetylated,such as, but not limited to, at least partially deacetylated chitosan,for example. The degree of deacetylation, in chitosan, for example, maybe greater than 75%. Chitosan may be water insoluble be made to be watersoluble by being deacetylated, for example.

The antimicrobial metal, antimicrobial metal compound, or antimicrobialmetal ion may comprise silver, copper, or zinc, for example.

The water soluble metal iodide, water soluble metal fluoride, and watersoluble metal chloride may comprise, but not limited to, a water solublesilver compound such as silver fluoride and silver diamine fluoride, orsodium fluoride, for example.

The antimicrobial metal, antimicrobial metal compound, or antimicrobialmetal ion may have a diameter of less than 100 nm to facilitate traveland deposition within the dentinal tubule.

Embodiments of the method of the invention may be directed to a methodof occluding dentinal tubules. One such embodiment of the method ofoccluding dentinal tubules in a tooth comprises applying an amount of amedical device or solution describe herein to a treatment area of the atleast one tooth. The method may further comprise drying the tooth and/orapplying a covering agent over the treatment area of the tooth.

Therefore, an embodiment of the method of occluding dentinal tubules ina tooth comprises drying at least one tooth, applying an effectiveamount of a medical device or solution to a treatment area of the atleast one tooth. The medical device or solution may comprise a solutioncomprising a polysaccharide or other biocompatible polymer, anantimicrobial metal or metal ion bound to the polysaccharide or otherbiocompatible polymer, and an antimicrobial metal fluoride encompassedwithin the nanoparticle gel, and applying a covering agent over thetreatment area of the tooth.

Drying the at least one tooth may also comprise desiccating at least onedentinal tubule to form a desiccated tubule. The polysaccharide or otherbiocompatible polymer may bind to bacteria within the desiccated tubuleto deliver the antimicrobial and other components of the medical device.An antimicrobial metal fluoride in the medical device or solution(silver fluoride, for example) may form a fluorapatite when bindingwithin the tooth to at least partially occlude a dentinal tubule.

In one embodiment, the medical device comprises a biocompatible polymer(biopolymer) and a metal bound to the biopolymer. The medical device mayfurther comprise a solution for the biopolymer. In some furtherembodiments, a fluoride or a fluoride containing compound may also bebound to the biopolymer or in solution with the biopolymer. The metaland/or the fluoride may be bound to the biopolymer by any chemicalbonding or caged in a polymer matrix, for example. The chemical bondingmay be covalent, ionic, hydrogen bonding or van der Waal forces. Themetal may have antimicrobial properties and more specifically a metalthat has antimicrobial properties toward microbes that are detrimentalto dental health.

The antimicrobial metal may include metal ions selected from the groupcomprising silver ions, copper ions, zinc ions or a combination thereof,as antimicrobial metal ions and/or a metal selected from the groupcomprising silver, copper, zinc, or a combination thereof, as anantimicrobial metal in a metal state.

Some microbes that are detrimental to oral health. In some embodiments,the biopolymer is capable of binding to the surface of the cell walls ofgram negative or gram positive bacteria.

The biopolymer may be a biocompatible polymer. The biocompatible polymermay be a carbohydrate. The carbohydrate may be a natural or syntheticcarbohydrate. The carbohydrate may be modified with the addition offunctionality that more effectively bind to bacterial cell walls. Forexample, the polymer may comprise functional groups that attached tobacterial cell walls to more effectively deliver the antimicrobial metalto the bacteria. The biocompatible polymer can be sized such that thebiopolymer and/or the solution may be drawn into a dentinal tubule. Thebiocompatible polymer may be a biodegradable polymer. In one embodiment,the biopolymer is chitosan. Chitosan is a deacetylated product ofchitin. Chitosan has been found to have antimicrobial activity withouttoxicity to humans. Chitosan has been derived from the outer skeletonsof crustaceans, mollusks, insects, and fungi. In a preferred embodiment,the chitosan is derived from fungal sources. The medical device maycomprise other polysaccharides and/or functionalized or defunctionalizedpolysaccharides.

Disclosed may be a device and method for treating dental disease, whichis made up of the following components metal, biopolymer, and fluoride.These components are connected in a liquid suspension as follows themetal is bound to biopolymer covalently and on a different amino groupfluoride may be covalently bonded. These components in solution can beapplied to an area of dental disease to kill or inhibit bacteria,remineralize the dentin and/or the enamel of the tooth, and occludeexposed dentinal tubules.

The device may also have one or more of the following: (1) the metals ormetal ions, the metals or metal ions may be nanoscale particles, (2)multiple metals or metal ions bound to the biopolymer, (3) thebiopolymer may be capable of biodegrading, (4) the fluoride or fluoridecompound may or may not be bound to the biopolymer, for example, thefluoride may instead in the solution or not present at all.

Embodiments of a method may comprise the associated method may alsoinclude one or more of the following steps: (1) the substances may bebound by metallic, covalent or ionic bonds, (2) the solution may bewater based, (3) the solution may be activated by physical, thermal orchemical means to promote biopolymer-metal bonding, and/or (4) thesolution may be applied using a brush to areas of dental disease orhypersensitivity.

The disclosed device is unique when compared with other known devicesand solutions because it provides: (1) bactericidal activity at lowconcentrations; (2) chemical complexes at nanoscale proportions; and (3)biopolymer bound and/or free molecules of fluoride. Similarly, theassociated method is unique in that it: (1) is minimally invasive; (2)cost-effective; and (3) easily applied. Similarly, the disclosed methodis unique when compared with other known processes and solutions in thatit: (1) doesn't significantly stain teeth or tissues; (2) doesn't causean uncomfortable burning sensation; and (3) binds within the dentinaltubules and partially biodegrades providing a sustained release ofsilver and fluoride.

The disclosed device is unique in that it is structurally different fromother known devices or solutions. More specifically, in one embodiment,the device comprises: (1) nano-silver and fluoride bound tolow-molecular weight chitosan; and (2) unbound sodium fluoride (NaF).These components may be any effective concentration in the liquidsolution or suspension to occlude a dentinal tubule and reduce toothsensitivity.

In one embodiment, the components (as measured in parts per million inthe liquid) may be in a ratio of fluoride ion:chitosan:nanosilver of theratio of 20:10:1. For example, in one embodiment, the components may be44,000 ppm fluoride (4.4 wt. %), 20,000 ppm chitosan (2.0 wt %), 2,000ppm nanosilver (0.2 wt. %) in the liquid suspension or solution. Moregenerally, the ratio of components may be fluoride ion:Chitosan may be0.5-4.0:1 and fluoride ion:nanosilver 5-40:1.

An embodiment of the medical device or solution comprises a solvent, abiopolymer in a range of 0.1 wt. % to the weight percent of solubilitylimit of the biopolymer in the solvent, nanosilver in a range of 0.05 wt% to the weight percent of the solubility of the biopolymer in thesolvent; and 0.01 wt % to 0.5 wt % of fluoride ion.

Another embodiment of the medical device or solution comprises asolvent, a biopolymer in a range of 0.1 wt. % to the 10 wt. %;nanosilver in a range of 0.05 wt % to 6 wt. %; and fluoride ion in arange of 0.01 wt % to 0.5 wt %. In these embodiments, the nanosilver maybe bound to the biopolymer. Also in these embodiments, the biopolymermay be a deacylated chitosan.

Furthermore, the process associated with the aforementioned device islikewise unique. More specifically, the disclosed process owes itsuniqueness to the fact that it: (1) the chitosan used may be purified orreacted to be a chitosan polymer having a lower molecular weight and ahigh degree of deacetylation; (2) fluoride and nanospheres or othernanoparticles of silver are added in less than equal concentrations tochitosan and bound via methods known to the arts; and (3) sodiumfluoride (NaF) is added in less than equal concentration to thepreviously formed molecule while titrating for neutral pH.

The embodiments of the described methods and the medical devices andsolutions are not limited to the embodiments, components, method steps,and materials disclosed herein as such components, process steps, andmaterials may vary. Moreover, the terminology employed herein is used todescribing exemplary embodiments only and the terminology is notintended to be limiting since the scope of the various embodiments ofthe present invention will be limited only by the appended claims andequivalents thereof

Therefore, while embodiments of the invention are described withreference to exemplary embodiments, those skilled in the art willunderstand that variations and modifications can be affected within thescope of the invention as defined in the appended claims. Accordingly,the scope of the various embodiments of the present invention should notbe limited to the above discussed embodiments and should only be definedby the following claims and all equivalents.

This disclosure will now provide a more detailed and specificdescription that will refer to the accompanying drawings. The drawingsand specific descriptions of the drawings, as well as any specific oralternative embodiments discussed, are intended to be read inconjunction with the entirety of this disclosure. The Medical device andmethod for the treatment of dental disease may, however, be embodied inmany different forms and should not be construed as being limited to theembodiments set forth herein; rather, these embodiments are provided byway of illustration only and so that this disclosure will be thorough,complete and fully convey understanding to those skilled in the art.

DETAILED DESCRIPTION

The present invention is directed to a medical device or a solution andmethod for the treatment of dental disease. In one embodiment, themedical device or solution comprises nanospheres or other nanoparticlescomprising a biocompatible polymer and silver or other antimicrobialmetal. The medical device may be applied to a tooth comprising dentinaltubules. The exposed dentinal tubules may be causing discomfort due toenamel wear, decay, or other thinning of the enamel. The medical deviceor solution is capable of being drawn into the dentinal tubule by theapplication of pressure or capillary action, for example. Within thetubule, the biocompatible polymer may attach to any bacteria or othermicrobes and the silver or other antimicrobial metal carried on thebiocompatible polymer within the tubule may then kill the bacteria ormicrobe.

It is desirable to have a medical device or a solution that may beapplied to a tooth that can easily kill and inhibit bacteria which causedental disease and to occlude dentinal tubules. The disclosed medicaldevice or solution and associated method of applying the medical deviceor solution advantageously provides a solution to kill and inhibitbacteria while simultaneously at least partially sealing the dentinaltubule and repairing the tooth.

As such, the invention is directed to a medical device or solution foroccluding a dentinal tubule. Dentinal tubules are microscopic channelsthat extend from the enamel surface of a tooth to the inside pulp.Dentin is the major structural component and middle layer of the toothand supports the brittle enamel on the exterior surface of the tooth.

These small, hollow dentinal tubules through the dentin facilitateconveyance of sensations from the outside of the tooth to the insidetoward the nerve. However, if the enamel is eroded or thinned, thesesensations may be increased, and the sensitivity of the tooth can beuncomfortable or cause discomfort to a person.

To reduce the discomfort, the exposed dentinal tubules may need to beoccluded. As described herein, a medical device or solution may beapplied to the tooth to occlude the dentinal tubule. In one embodiment,the medical device or solution may comprise a nanogel, nanoparticle orother polymer carrier to deliver an antimicrobial into the dentinaltubule to kill microbes and also seal dentinal tubule to easediscomfort.

An embodiment of the medical device or solution for treating andoccluding dentinal tubules comprises a nanoparticle comprising chitosanand a silver nanoparticle bound to the chitosan. Further incorporated inthe nanoparticle may be a silver fluoride. Fluoride ions can react withfree calcium ions to form deposits of calcium fluoride that can blockdentinal tubules. The medical device may be drawn into a dental tubuleby capillary action, wherein the chitosan may attach to any bacteria ormicrobes within the tubule and the antimicrobial silver nanoparticleand/or the silver fluoride may kill the bacteria or other microbe. Thefluoride ions may then react with the calcium to form deposits withinthe dentinal tubule. Additionally, the nanoparticles may also remain inthe tubule to occlude the tubule and reduce discomfort. In anembodiment, all the active components of the medical device or solutionmay be water soluble and the medical device or solution is a water basedsolution.

In another embodiment, the medical device or solution may comprise apolysaccharide or other biocompatible polymer; an antimicrobial metal,antimicrobial metal compound, or antimicrobial metal ion nanoparticlebound to the polysaccharide or other biocompatible polymer. The medicaldevice may further comprise at least one of a water soluble metaliodide, water soluble metal fluoride, and water soluble metal chlorideencompassed within the nanogel or polymer.

Biocompatible Polymers

The polysaccharide may include, but is not limited to, chitosan,dextran, or other low molecular weight polysaccharide. Thepolysaccharide may be a copolymer comprising a polysaccharide. Thechitosan, dextran, nanogel, or other biocompatible polymer may have amolecular weight from 50,000-200,000 Da. The polysaccharide, chitosan,dextran, or other biocompatible polymer may be modified. For example,such polymers may be at least partially deacetylated, such as, but notlimited to, an at least partially deacetylated chitosan.

A biocompatible polymer is a polymer that does not produce toxin orharmful products to human body or cells or stimulates an immune responsein biological systems. This is preferred so that during implantation,the material does not induce a rejection response. The biocompatiblepolymers include, but are not limited to, polysaccharides, chitosan,dextran, modified polysaccharides, modified chitosan, modified dextran,copolymers thereof, and combinations thereof. The biocompatible polymersmay be low molecular weight polymers, such as, having a molecular weightless than 200,000 daltons, or greater than 20,000 Daltons and less than200,000. Such low molecular weight biocompatible polymers will moreeasily be deposited within the dentinal tubule. For example, the polymermay be a low molecular weight chitosan with a molecular weight more than20,000 Daltons and less than 200,000 daltons.

The term “polysaccharide” further includes polysaccharides that havebeen modified by a reaction of its hydroxyl groups or other group with acompound to a different pendent functional group. The biopolymer may bea biodegradable polysaccharide. As used herein, “biodegradablepolysaccharides” are polysaccharides that are biodegradable by enzymespresent in a human. Additionally, the polysaccharide hydroxyl groupsprovide a vehicle for producing “tunable” hydrogels.

In some embodiments, the polysaccharide may be a polysaccharide ofD-glucose monomers, linked by glycosidic bonds. Glucans include thefollowing: dextran (α-1,6-glucan with α-1,3-branches); glycogen (α-1,4-and α-1,6-glucan); pullulan (α-1,4- and α-1,6-glucan); starch (α-1,4-and α-1,6-glucan); cellulose (β-1,4-glucan); chrysolaminarin(β-1,3-glucan); curdlan (β-1,3-glucan); laminarin (β-1,3- and(β-1,6-glucan);lentinan (a strictly purified (β-1,6: β-1,3-glucan fromLentinus edodes); lichenin (β-1,3- and (β-1,4-glucan); oat beta-glucan(β-1,3- and β-1,4-glucan); pleuran (β-1,3- and (β-1,6-glucan isolatedfrom Pleurotus ostreatus); and zymosan β-1,3-glucan). Otherbiodegradable/biocompatible polysaccharides include chitosan, which is alinear polysaccharide composed of randomly distributed (β-(1-4)-linkedD-glucosamine and N-acetyl-D-glucosamine, and hyaluronic acid.Hyaluronic acid is a polymer of disaccharides, themselves composed ofD-glucuronic acid and D-N-acetylglucosamine, linked via alternatingβ-1,4 and β-1,3 glycosidic bonds.

In some embodiments comprising nanospheres or other nanoparticles, thenanospheres or other nanoparticles have a diameter of greater than 1 nmand less than 100 nm.

The biocompatible polymer, for example, chitosan, dextran or derivativethereof, may decompose within the dentinal tubule to deposit the othercomponents within the tubule to facilitate its occlusion.

Antimicrobial Metal Nanoparticles

The medical device of solution may comprise an antimicrobial metalnanosphere or nanoparticle bound to the biocompatible polymer. Theantimicrobial metal nanoparticle may be any particle that may kill orretard growth any bacteria or other microbe within the dental complex ora dentinal tubule and may occlude the tubule to prevent furtherdiscomfort in the patient.

The antimicrobial metal nanosphere or nanoparticle may comprise metalions selected from the group comprising silver ions, copper ions, zincions or a combination thereof, as antimicrobial metal ions and/or ametal selected from the group comprising silver, copper, zinc, or acombination thereof

In certain embodiments, the medical device or solution may comprisemetal fluoride or other fluoride (such as, for example, silver fluoride)bound to biocompatible polymer in a 40:60 to 60:40 ratio, for example.In such an embodiment the biocompatible polymer may be chitosan and thefluoride may be silver fluoride, for example. The antimicrobial metalfluoride may form a fluorapatite when binding with the tooth to occludethe dentinal tubule.

Additional Antimicrobial

The medical device may comprise an additional antimicrobial that is notbound to the biocompatible polymer.

For example, fluoride bound to sodium or silver, in the form of sodiumfluoride (NaF) or silver fluoride (AgF) may be encompassed within thenanogel or nanoparticle. In certain embodiments, the additional fluoridemay be in approximately equal concentration to the chitosan. Thecomponents may be any effective concentration in the liquid solution orsuspension. In one embodiment, the components (as measured in parts permillion in the liquid) may be in a ratio of fluorideion:Chitosan:nanosilver of about 20: about 10: about 1. For example, inone embodiment, the components may be 44,000 ppm fluoride, 20,000 ppmchitosan, 2,000 ppm nanosilver in the liquid suspension or solution.More generally, the ratio of components may be fluoride ion:Chitosan maybe between 0.5 and 4.0:1 (or between 1 and 3:1, for example) andfluoride ion:nanosilver may be between 5 and 40:1 (or between 10 and30:1, for example).

These components may be bound together chemically as follows by anychemical, thermal, electrical or through any type of irradiation. Itshould further be noted that, the components are suspended in a liquidsuspension. Preferably the medical device or solution may be buffered toa pH of approximately neutral (5.5 to 7.5) and having a totalconcentration of active ingredients of 2 wt. % to 30 wt. %. The boundsilver may resist oxidization and, therefore, no color, change wouldoccur with the application of the medical device or solution to thetooth or in the oral cavity.

An embodiment of performing the method associated with the discloseddevice comprise the following steps: isolating and drying of the tooth,using a microbrush to apply a drop of the disclosed solution to theaffected area, applying a covering agent over the affected area. Itshould further be noted that: the drying of the tooth dessicatesdentinal tubules, that the disclosed invention is of such a scale thatit would flow within the desicated tubules by capillary action, that thebiopolymer or chitosan would bind to bacteria within the dentinaltubules, that the components would act to kill the bacteria and seal thedentinal tubules, that the fluoride would form fluorapatite when bindingwith the tooth. A dental restoration could be placed directly after orat a later date to seal the tooth or for cosmetic reasons.

A specific embodiment of the medical device and solution may comprisechitosan, silver nanoparticle, and silver fluoride or sodium fluoride.The chitosan may be a modified chitosan, such as an at least partiallydeacetylated chitosan. The silver nanoparticle may be bonded to thechitosan.

In one such embodiment, the medical device or solution compriseschitosan in a range of 10,000 ppm to 30,000 ppm, nanosilver in a rangeof 100 ppm to 8,000 ppm, and fluoride ions (from silver fluoride orsodium fluoride, for example) in a range of 10,000 ppm to 45,000 ppm.

In another embodiment, the medical device or solution comprises chitosanin a ratio of silver fluoride or sodium fluoride in a range of 1:1 to15:1. In another embodiment, medical device or solution compriseschitosan in a ratio to silver fluoride or sodium fluoride in a range ofbetween 2:1 and 20:1.

In an embodiment, the medical device or solution comprises a ratio ofchitosan to nanosilver may be in a range of 30:1 to 2:1. In anotherembodiment, the medical device or solution comprises a ratio of chitosanto nanosilver may be in a range of 30:1 to 5:1.

Method of Occluding Dentinal Tubules

The invention is also directed to methods of occluding a dentinal tubulein a tooth. An embodiment of the method of occluding dentinal tubules inteeth comprises applying an amount of a medical device or solution asdescribed herein to the treatment area of the at least one tooth. Themedical device or solution enters the dentinal tubule by any meansincluding, but not limited to, pressure, gravity, capillary action, forexample.

The method may be performed by a medical professional such as but notlimited to a dentist, a dental hygienist, a dental assistant, or otheraid. The method performed by the medical professional may compriseapplying the medical device or solution to at least one tooth with abrush. The brush may be a microbrush applicator or other dentalapplicator.

To assist in the medical device or solution in entering the dentinaltubule, the tooth may be dried prior to application of the medicaldevice or solution. By drying the tooth, any water or other volatileliquids in the dentinal tubule are at least partially removed thereby atleast partially emptying the dentinal tubule. The method may, therefore,comprise desiccating at least one dentinal tubule to form a desiccatedtubule.

This provides free space for the medical device or solution to enter thedentinal tubule and will increase the capillary action within thedentinal tubule. To further assist the medical device or solutionentering the dentinal tubule, the method may include applying a coveringagent over the treatment area of the tooth. The covering helps themedical device or solution remain on the treatment area for a longerperiod of time.

Therefore, the method of occluding dentinal tubules in teeth maycomprise drying a treatment area of at least one tooth, applying anamount of a medical device to the treatment area of the at least onetooth, wherein the medical device as described herein, and applying acovering agent over the treatment area of the tooth. For example, themedical device or solution may comprise a polysaccharide; anantimicrobial metal or metal ion nanoparticle bound to the low molecularweight polysaccharide to form a nanoparticle gel and an antimicrobialmetal fluoride encompassed within the nanoparticle gel.

Embodiments of the method may further comprise isolating the tooth. Themethod of isolating the tooth may be any method known in the art.Applying the medical device or solution may be done by any meansincluding, but not limited to, pouring, spraying, dropping, or brushing,for example. In one embodiment, the method comprises applying aneffective amount the medical device or solution using a microbrush toapply a drop of the solution.

Different features, variations and multiple different embodiments havebeen shown and described with various details. What has been describedin this application at times in terms of specific embodiments is donefor illustrative purposes only and without the intent to limit orsuggest that what has been conceived is only one particular embodimentor specific embodiments. It is to be understood that this disclosure isnot limited to any single specific embodiments or enumerated variations.Many modifications, variations and other embodiments will come to mindof those skilled in the art, and which are intended to be and are infact covered by both this disclosure. It is indeed intended that thescope of this disclosure should be determined by a proper legalinterpretation and construction of the disclosure, includingequivalents, as understood by those of skill in the art relying upon thecomplete disclosure present at the time of filing.

1. A medical device, comprising: a nanogel, comprising: a polysaccharideor other biocompatible polymer; and an antimicrobial metal,antimicrobial metal compound, or antimicrobial metal ion bound to abiopolymer ; and at least one of a water soluble metal iodide, watersoluble metal fluoride, and water soluble metal chloride encompassedwith the nanogel.
 2. The medical device of claim 1, wherein theantimicrobial metal or metal ions have a diameter of less than 100 nm.3. The medical device or solution of claim 2, wherein the nanogelcomprises a polysaccharide.
 4. The medical device or solution of claim3, wherein the polysaccharide is a chitosan.
 5. The medical device orsolution of claim 4, wherein the chitosan has a molecular weight from50,000-200,000 Da.
 6. The medical device or solution of claim 1, whereinthe nanogel comprises a biocompatible polymer.
 7. The medical device orsolution of claim 5, wherein the chitosan is an at least partiallydeacetylated chitosan.
 8. The medical device or solution of claim 1,wherein the water soluble metal iodide, water soluble metal fluoride,and water soluble metal chloride is silver fluoride.
 9. The medicaldevice or solution of claim 1, wherein the antimicrobial metal,antimicrobial metal compound, or antimicrobial metal ion is one ofsilver, copper, and zinc.
 10. The medical device or solution of claim 1,wherein the antimicrobial metal, antimicrobial metal compound, orantimicrobial metal ion is silver.
 11. The medical device or solution ofclaim 9, wherein the at least one of a water soluble metal iodide, watersoluble metal fluoride, and water soluble metal chloride is a sodiumfluoride or a silver fluoride.
 12. The medical device or solution ofclaim 10, wherein the at least one of a water soluble metal iodide,water soluble metal fluoride, and water soluble metal chloride is silverfluoride.
 13. The medical device or solution of claim 10, wherein thesodium fluoride or silver fluoride is free in equal concentration to thechitosan.
 14. The medical device or solution of claim 1, wherein themedical device or solution has a neutral pH.
 15. The medical device orsolution of claim 1, wherein the total concentration of theantimicrobial metal, antimicrobial metal compound, or antimicrobialmetal ion, nanogel, and at least one of a water soluble metal iodide,water soluble metal fluoride, and water soluble metal chloride isbetween 5 wt. % and 50 wt. % of the medical device or solution.
 16. Themedical device or solution of claim 1, wherein the total concentrationof the antimicrobial metal, antimicrobial metal compound, orantimicrobial metal ion, nanogel, and at least one of a water solublemetal iodide, water soluble metal fluoride, and water soluble metalchloride is between 5 wt. % and 50 wt. % of the medical device orsolution.
 17. A method of occluding dentinal tubules in teeth,comprising: drying at least one tooth; applying an amount of a medicaldevice to the treatment area of the at least one tooth; and applying acovering agent over the treatment area of the tooth.
 18. A method ofoccluding dentinal tubules in teeth, comprising: drying at least onetooth; applying an amount of a medical device to the treatment area ofthe at least one tooth, wherein the medical device comprises: asolution, comprising: a polysaccharide; an antimicrobial metal or metalion bound to the low molecular weight polysaccharide to form ananoparticle gel; and an antimicrobial metal fluoride encompassed withinthe nanoparticle gel; and applying a covering agent over the treatmentarea of the tooth.
 19. The method of claim 16, further comprisingisolating the tooth.
 20. The method of claim 17, wherein the applying anamount the medical device or solution comprises using a microbrush toapply a drop of the solution.
 21. The method of claim 16, wherein dryingat least one tooth comprises desiccating at least one dentinal tubule toform a desiccated tubule.
 22. The method of claim 19, wherein thepolysaccharide is drawn into the desiccated tubule by capillary action.23. The method of claim 20, wherein the polysaccharide binds to bacteriawithin the desiccated tubule.
 24. The method of claim 21, wherein thepolysaccharide is a chitosan.
 25. The method of claim 16, wherein themedical device or solution kills the bacteria and seals the dentinaltubules.
 26. The method of claim 23, wherein the antimicrobial metalfluoride forms fluorapatite when binding with the tooth.